Program evaluation as applied to the goals of a psychology department clinic.

Abstract

A comprehensive evaluation of a psychology department clinic in relation to its goals was planned and carried out. Because several overlapping administrative divisions of the university shared responsibility Jar the clinic and formulated its goals in different ways, an empirical strategy for goal definition based on observation of clinical faculty members and students was adopted-The observations demonstrated that overall, clinic goals were in fact determined by departmental priorities that put training first and research and service in a joint second position. An evaluation instrument composed of five segments was constructed to gauge goal attainment. The segments covered (a) graduate students' evaluation of the training they received through the clinic, (b) faculty members' views of the effects of the training program, (c) the adequacy of the training program as reflected in the postdoctoral accomplishments of former students, {d} community awareness of and attitude toward the clinic, and (e) clients' satisfaction with clinic services. Existing scales were used when available.Psychology department clinics have long been recognized as playing an important role in the development of clinical psychology (Brotemarkle, 1947;Seeman, 1968) and in the maintenance of a sound clinical program within a graduate department (American Psychological Association Education and Training Board, 1967). The effectiveness of clinic programs has seldom been formally evaluated (Harway & Serafica, 1977), however, and although ongoing informal evaluations of both process and outcome variables in the clinic may be a common state of affairs, few, if any, reports of clinic evaluations have been published. IssuesAn important exception is an essay by Harway and Serafica (1977) that articulated several important issues on the basis of the authors' experience in conducting a survey of American Psychological Association (APA)-approved graduate programs in clinical psychology and an evaluation of a psychology clinic. Their principal conclusions that (a) the organization's structure and functional characteristics set limits to the application of particular evaluation strategies, (b) goal-attainment, decision-theoretic, and systems approaches can profitably be combined for the purpose of understanding the departmental clinic, and (c) self-evaluation by the participants of the program rather than evaluation by an external, independent team may be the most productive approach, (p. 656) These conclusions were an important contribution to the planning of an evaluation of the psychology clinic at the University of Montana. The occasion for the evaluation was the appointment of a new director of clinical training for the program.

Review of research conducted in psychology program training clinics.

“…Hannum's analysis, which was based on his experience as a TC director as well as on survey findings and published case studies, offered several topics for further investigation. This analysis indicated, for example, that decentralization and faculty autonomy in academic settings impedes the resolution of conflict about priorities (see also Walsh et al, 1985), that the TC director is encouraged to become either an endless negotiator or an independent dictator, and that these tensions can be eased by the development of a steering committee of representatives of the groups that have an interest in the clinic. Hannum's (1988) analysis, in contrast to studies that have tended to focus on the modal clinic, pointed the way toward a more differentiated understanding of alternative organizational designs for TCs that might suit different situations and priorities and have different implications for training, research, and service (Brunk, 1991).…”

“…Harway and Serafica (1977) acknowledged the potential for multiple and conflicting goals and values among those involved in TCs, as well as the potential in these settings for evaluation to serve educational as well as research needs. An evaluation of the TC at the University of Montana by Walsh et al (1985) was based heavily on the recommendations of Harway and Serafica (1977). Walsh et al affirmed the difficulty and importance of understanding organizational structure, including the potential for "difference in emphasis on the clinic's instructional, research, and service functions" (p. 663).…”

“…Various researchers have addressed the nature and organization of TCs. These studies include two surveys focused directly on organizational issues (Calhoun & Green, 1984; Serafica & Harway, 1980), additional surveys on more specific topics such as after-hours coverage (Bernstein, Feldberg, & Brown, 1991), and an assortment of organizational case studies (Bry, 1992; Kausch & Leventhal, 1972; Levine & Wishner, 1977; Wapner et al, 1984) and program evaluations (Aronson, Akamatsu, & Page, 1982; Harway & Serafica, 1977; Stevenson, Norcross, King, & Tobin, 1984; Walsh et al, 1985). One major focus has been on the relationships among goals, priorities, and organizational structure, whereas another set of issues concerns service delivery, staffing, and clinical policy.…”

“…Hannum's analysis, which was based on his experience as a TC director as well as on survey findings and published case studies, offered several topics for further investigation. This analysis indicated, for example, that decentralization and faculty autonomy in academic settings impedes the resolution of conflict about priorities (see also Walsh et al, 1985), that the TC directors is encouraged to become either an endless negotiator or an independent dictator, and that these tensions can be eased by the development of a steering committee of representatives of the groups that have an interest in the clinic.…”

“…Halgin identified two issues in addition to the problem of the homogeneity of clients, which was already mentioned above: (a) significant discrepancies in how clients and therapists described the reasons for termination and (b) clients' concerns about how the training aspects of the clinic may have impinged on their treatment. Walsh et al (1985) planned to conduct client follow-up evaluations of services but found it too difficult to contact clients in a high-mobility community. Similar difficulties may face many clinics in academic communities, and strategies for dealing with these problems are needed.…”